Becker's Hospital Review

27 mental health. Many of the issues that affect health have little or no connec- tion to the medical side of peoples' lives. You have to realize this if you want to have a long-term, sustainable effect on peoples' lives. This isn't really talk- ed about since we're in the medical care business, but we need to be in the health management business, especially when you're treating people from different economic groups. D.G.: I think there are three key elements to successful population health: evidenced-based medicine, engaging patients (through shared decision making, personalized care and education) and aligning financial incen- tives (through physician payment, panels and networks and our own in- surance products). Everything has to be aligned to ensure we are focusing on value for the patient, rather than volume. I'm excited for the transition. C.S.: We are deeply clinically affiliated with Partners HealthCare in Boston. We're working with them very closely to implement population health management programs. That will continue. There are three elements of a successful population health management program. 1) You have to have really good, useful patient information that will inform the clinical decision-making. That means you have to have IT systems that talk to each other and that are integrated within the whole network of care. 2) You need a strong primary care network. The PCP has to be quarterback of the care delivery team. They have to be able to play of- fense and defense. We also have to start incorporating nonclinical staff roles into this model. 3) There needs to be patient engagement and community integration. Patients have to play a much more active role in their health and wellness and not just go to the doctor's office when they're sick. You also need to be working with the community; no longer being a functional silo but working with the community to keep people in their homes by sup- porting them socially and economically. It takes a 'medical' village. S.B.: Obviously, there are many skill sets a health system needs to be suc- cessful in a population health model. First, we must create convenience and easily accessible primary care. We must be good at clinical data management. We must be good at creating the right financial structures and incentives. Most importantly, we must understand and address the healthcare disparities in the communities we serve. But I think the overarching principle that must guide our work in these ar- eas is to have a nimbleness and a flexibility to make adjustments along the way. A lot of this is brand new territory and we must be willing to adapt as we go. We need to create a learning environment that is measuring results at every step and having the discipline to adjust. Q: What do you think is the most important leadership quality? M.D.: The ability to inspire. To get people excited. To get them to want to do something, not because they have to, but because they want to. To create an environment where people wake up in the morning and look forward to coming to work. And finally to build a team and interdisciplin- ary approach to how we handle issues. D.G.: Emotional intelligence, which I would describe as the ability to con- nect with people, build relationships, establish trust and empathy and motivate people to do the best work they can. To me, that's how you do it. C.S.: Listening and bringing people together around a common goal. If you put the patient in the center of everything, it's very easy to have a dia- logue. As a chief executive, the most important thing you can do is listen to your staff, patients and community, and that helps inform my decisions. Taking that approach has never let me down. S.B.: I think the best leaders have an innate ability to answer the two prima- ry questions that are on everyone's mind in any organization. Where are we going? How are we going to get there? Leaders are responsible for rallying the organization around an agreed-upon objective. It's not only about get- ting the team organized and aligned; but about getting them excited about the journey. The new healthcare landscape will favor those organizations that are bold, innovative and courageous. That takes a team of passionate people who understand the vision. This is job number one of any CEO. Q: How would you describe your leadership style? M.D.: I think my style, in many ways, is about working around people and being very participatory. The key to leadership is to be able to identify the leadership abilities in everyone who works with you in the organization, and to allow them to realize, expose and take advantage of their own tal- ents. Face-to-face time is also important to me, as is being visible. Don't hide in your office. When people say it's lonely at the top it's because they don't get out to look around. D.G.: I hope my style is one of high emotional intelligence. I think the role of the hospital administrator is often chief cheerleader. We want to have talented people who feel empowered and motivated to do their work, and also hold them accountable. Leadership is about creating the struc- ture that allows them to do this. C.S.: I asked my team during a meeting and they described my leadership style as inclusive, collaborative, team-oriented and results-oriented. I think, being a nurse, you always learn to work as a team, and I was also very active in sports growing up. I can't imagine being in a job where you don't work with a lot of people. The best part of the job is tackling all of these chal- lenges with a group of people who share a passion for patient care. S.B.: I'd like to think that I bring an openness and transparency. I'm a big believer that it's best to lay everything out on the table. It's really the only way to create a truly collaborative atmosphere. I think this is the most challenging times to work in healthcare – but it's also most exhilarating time to work in healthcare. The team at Presence is such a remarkable col- lection of talent that I find it thrilling to come to work. Q: Who is your biggest inspiration as a leader and why? M.D.: The person I read a lot about is [Winston] Churchill. He was an un- believable leader who took positions contrary to those most people in his country took at the time, but he made a huge impact on the world as we know it. He had his ups and downs but he always moved forward, even when he failed. Also, President Franklin Delano Roosevelt. When you look historically at leaders and the world that they lived in, the difficulties they encountered makes the things we deal with today seem pretty minor. This historical perspective is important. C.S.: My dad, who passed away nine years ago, used to own a small phar- macy. When I was a little kid I used to go to work with him and it always impressed me how he always put the patient who came in for medicine at the center. He also had to have a retail part of the store to make money. He had a soda fountain, he sold seasonal things; ultimately, he kept the store alive by being innovative and creative. I currently have a board member, Mike Zak, who is a partner at Charles River Ventures. What I love about Mike is that he constantly challenges me to be in- novative, take risks and have the courage to try creative things. He's a mentor in many ways, and I feel the hospital and our community have benefited from him challenging me, and subsequently me challenging my team and always pushing the envelope. He taught me it's okay to try things even if they don't work, but in the end, they usually do. That's why we've been so successful. S.B.: My biggest inspiration is Sister Carol Keehan, president and CEO of the Catholic Health Association of the United States. She had the courage to stand up for her convictions to help bring about the passage of the Pa- tient Protection and Affordable Care Act. I admire her strength in standing up for what she believed and she has been applauded across the United States for having secured the necessary votes. n "DON'T HIDE IN YOUR OFFICE. WHEN PEOPLE SAY IT'S LONELY AT THE TOP, IT'S BECAUSE THEY DON'T GET OUT TO LOOK AROUND." — MICHAEL DOWLING

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